Clinical Chemistry

The fellowship is a one- or two-year program that provides MD pathologists and PhD scientists with analytical, clinical, research, and management experience towards specialization in clinical chemistry. The Chemistry Division performs over seven million tests each year and provides 24 hour service to The Johns Hopkins Hospital, the Bayview Medical Center, and several community outpatient facilities. The fellow rotates through routine automated chemistry (high volume testing), critical care (blood gases, stat testing), special chemistry (immunoassay for endocrine function and tumor markers, trace metal analysis) and toxicology (analysis of therapeutic and abused drugs). The program is designed to provide training in the operation of a clinical laboratory, quality control and assurance, laboratory management, analytical methodologies and test interferences. The clinical interpretation and diagnostic relevance of tests is emphasized through clinical consults. Research projects could involve method development, test validation, clinical and scientific investigation in any of the areas within clinical chemistry and clinical proteomics. The structure of the program is flexible to afford individualized training based on previous experience.

Cytopathology

During this post-residency ACGME-accredited fellowship program, of one or preferably two years duration, the fellow will gain advanced experience in diagnosis, teaching, and research in clinical cytopathology. Diagnostic material consists of a wide variety of gynecologic and non-gynecologic specimens. Performance of superficial fine needle aspirations and on-site assessment of superficial and image guided deep aspirates provides the trainee with extensive expertise in this popular technique. Fellows are given increasing responsibility in cytopathology sign-out as they acquire experience, and participate as instructors in an internationally acclaimed continuing medical education program. Research opportunities in immunocytochemistry, morphometry and applied molecular pathology are available. The second year provides advanced experience in diagnostic cytopathology and in depth research and is tailored according to the trainee's interests and career path. Their position as a senior clinical fellow enables them to have sign-out responsibilities and to otherwise function at a junior faculty level. Goals of the program include preparation for the American Board of Pathology Added Qualification in Cytopathology exam, and an academic career, although fellows will find themselves superbly trained for a community practice in Cytopathology.

Gastrointestinal and Liver Pathology

Two programs are offered in gastrointestinal/liver pathology; a two-year program and a one-year fellowship.

The two-year program combines clinically oriented surgical and biopsy pathology of gastrointestinal case material for sign-out by Drs. Robert Anders, Belur Bhagavan, Christine A. Iacobuzio-Donahue, Anirban Maitra, Elizabeth Montgomery, and Michael Torbenson. This includes an active consult service for which the fellow is responsible.Specialty experience in liver disease is provided by Drs. John K. Boitnott, Michael Torbenson, and Robert Anders. Dr. Ralph Hruban, Director of the GI Pathology / Liver Division, provides diagnostic and research experience in pancreatic diseases.The fellow participates in clinical rounds and in housestaff and medical student teaching. In the second year the fellow is appointed an Assistant by The Johns Hopkins Hospital (a faculty level position) and takes full responsibility for sign-out of gastrointestinal case material. Research is an integral part of the program during both years and may have either a clinical or an experimental emphasis. There are multiple opportunities for collaborative studies in gastroenterology and in basic research in this and other departments.

In addition, a separate one year fellowship position in GI / Liver Pathology is offered. This fellowship parallels the two-year program, but does not include the sign-out opportunities of the two-year program.

Genitourinary Pathology

This is a one-year position combining clinical and research experience with Jonathan Epstein, MD. There are typically four full time fellows. The material comprises radical prostatectomy specimens, teaching sets covering the entire spectrum of urological pathology, and an active personal consult service with over 60 cases per day. A major role of the fellow is in participation in the research projects covering diverse subjects relating to genitourinary pathology.

Gynecologic Pathology

The program is ideal for individuals pursuing academic careers in surgical pathology and/or gynecologic pathology but is not restricted to such individuals. It is designed to be a combination of a fellowship and a junior faculty assistant position of two years duration. Variations of the program are possible, ranging from a single fellowship year to two full years as a faculty assistant. The program combines advanced training in diagnostic gynecologic pathology with clinical/translational/basic research and teaching. Clinical responsibilities: sign-out of in-house material and evaluation of consultation cases. Research: the fellows are engaged in research activities, which include clinicopathologic and immunohistochemical studies as well as basic and translational research. Current staff research interests: cervical, endometrial, and ovarian neoplasia; trophoblastic disease; HPV; and tumor genetics. Teaching: supervision and instruction of residents; presentation of cases at the gynecologic oncology tumor board, colposcopy correlation conference, and reproductive endocrinology and infertility conference.

Hematopathology

This is a one-year ACGME-accredited fellowship that emphasizes diagnostic aspects of hematopathology. Candidates must be Board eligible or certified in either anatomic pathology or anatomic and clinical pathology; combined training is preferred. The fellow is trained in morphologic examination of blood, bone marrow, and lymph nodes, and particular emphasis is given to use of ancillary techniques. The fellow has direct responsibility for flow cytometry and immunocytochemistry, and gains experience in cytogenetics and molecular pathology. In addition, the program includes exposure to coagulation and other aspects of laboratory hematology. The fellow interacts directly with the clinical staff in both adult and pediatric hematology and oncology and with physicians outside the Johns Hopkins Medical Institutions who submit material for consultation. There is significant flexibility for tailoring the fellowship to individual interests. Participation in research is encouraged and the potential exists for pursuing research in greater depth by extending the fellowship beyond a single year.

Informatics

The Informatics Division of the Department of Pathology offers a one- or two-year fellowship in informatics. The goals and organization of this fellowship can be tailored to the interests of the trainee. Areas of interest in medical informatics include:

Tools for integrating data stored in multiple medical databases;

Generation of medical knowledge bases using techniques for extracting and synthesizing information from clinical data;

Web tools for pathology and laboratory order-entry and result reporting;

Natural language retrieval systems;

Open source software in health care.

This program is intended primarily for individuals with residency training in pathology, although candidates with other professional backgrounds may be considered. Previous computer experience is required.

Immunology

This is a one-year program (with an option for 2nd year) that allows the successful candidate to function as a junior faculty member in the Immunology Laboratory. This service laboratory evaluates samples from patients with a variety of immune-mediated conditions, i.e. autoimmune disorders, monoclonal gammopathies, transplantation, and infectious diseases. The junior faculty member will participate with other pathology faculty in interpreting, reporting and signing-out cases addressing immunoglobulin abnormalities. This position is designed to provide advanced experience in clinical/diagnostic laboratory and teaching aspects of immune diseases. Research is an important component and strongly encouraged at both the experimental and clinical level in cytokine biology, transplantation, autoimmunity and tumor immunology. There is also potential for interdivisional collaboration in molecular oncology, immunopathology, neuropathology, transfusion medicine and immunohematology. Participation in clinical conferences and immunology-related seminars is also encouraged.

Requirements: Board eligible in CP or in AP/CP. A Maryland medical license is required prior to starting date. Start date: July 1, 2008.

Medical Microbiology

The Medical Microbiology Fellowship program is designed to provide in-depth experience and consulting expertise in the laboratory-based diagnosis of infectious diseases and to prepare the individual for a career in academic microbiology. The program is ACGME accredited in all major areas of microbial identification and susceptibility testing. The fellow will be responsible for designing and completing a clinical or basic science research project that requires application of microbiologic skills under the direction of a Microbiology Division faculty member. Successful fellows may be certified by the American Board of Pathology examination in Medical Microbiology. The core program is one year; an optional second year of research may be available.

Molecular Genetic Pathology Fellowship

Program(s): The molecular genetic pathology fellowship is an ACGME-accredited, one-year program designed to train individuals for academic careers including disease-oriented basic research, development of molecularly-based diagnostic technologies, and molecularly-oriented clinical research. More than 44 faculty members in the Departments of Pathology, Genetic Medicine and others teach or mentor research in this program. Training consists of a didactic course in molecular biology, introductory rotations through selected basic and applied laboratories, and an in-depth clinically-oriented experience under the direction of a faculty mentor. A research-oriented second year may be available to appropriate candidates. Current research activities include: molecular oncology including diagnostic development and fundamental neoplastic mechanisms, renal pathology, transplantation, immunopathology including HIV-related research, neuropathology focusing upon mechanisms of degenerative disorders, immunohematology, clinical chemistry, molecular microbiology, and comparative pathology. Fellows may incorporate genomic and proteomic approaches into their research making use of available departmental core facilities.

Requirements: Applicants should possess MD or equivalent doctoral degree and must have completed training in general pathology or medical genetics in an ACGME-accredited program. Exceptional PhD applicants with extensive clinical laboratory experience may also be considered.

Neuropathology

This ACGME-accredited fellowship program in experimental neuropathology is designed to teach new M.D., M.D.-Ph.D., and Ph.D. investigators basic science approaches to disorders of the nervous system. Major research efforts focus on the neurobiology/neuropathology and pathogenic mechanisms involved in a variety of illnesses, particularly the neurodegenerative diseases, including amyotrophic lateral sclerosis, Alzheimer's disease, Huntington's disease, and Parkinson's disease. In parallel, our group has examined in vitro and in vivo experimental systems with particular emphasis on animal models of neurodegenerative diseases. More recently, we have used gene targeting and transgenic approaches to define the function of specific gene products and to examine the consequences of introduction of disease-linked mutations into transgenic mice. These transgenic models are of great value for investigations of disease mechanisms and will be critical for testing novel therapies that, if efficacious in model systems, can be rapidly introduced into clinical trials. Other areas of high research priority are: neurotrophic factors and their influence on injured neurons; the biology of brain tumors with an emphasis on the roles of specific genes in neoplasm; and the mechanisms of cell injury in hypoxia-ischemia. Under individual faculty supervision, trainees work on several projects and become familiar with techniques of molecular neurobiology, biochemistry, ultrastructure, immunocytochemistry, receptor autoradiography, etc. A separate residency training program, leading to eligibility for Board certification in Neuropathology, is also available to individuals with prior training in Pathology or Neuropathology.

Renal Pathology

This one-to-two year program is ACGME-accredited for one year. The fellowship combines clinical and research experience. Clinical experience includes evaluation of transplant and non-transplant renal specimens utilizing light, immunofluorescence and electron microscopy. The service evaluates 1400-1500 renal biopsies per year; faculty include 3 academic nephropathologists and a senior laboratory manager. The fellowship is designed to provide graded clinical responsibilities, including on-call coverage as the trainee gains experience. Rotations include sessions in laboratory management and quality control. The fellow participates in clinical rounds with the Division of Nephrology in the Department of Medicine and the Division of Transplant Surgery in the Department of Surgery. Research is an integral part of the fellowship and may have either a clinical or experimental emphasis, with potential for interdepartmental collaboration as well. Faculty research interests include renal transplantation, acute tubular injury, tubular transport, and glomerular disease. The trainee also participates in teaching of medical students and residents. One position is available per year. Requirements: MD or MD/PhD, with three years AP training- board-eligible or board-certified.

Surgical Pathology

This is a one-year program that has features of an advanced fellowship allowing the individual to function as a junior faculty member (Assistant) on a surgical pathology service that accessions more than 75,000 specimens per year. The caseload is comprised of routine, consult and dermatopathology specimens. The responsibilities of this position include resident instruction, oversight of the grossing area, intraoperative frozen section evaluation, and independent sign-out of surgical pathology cases. There also is exposure to numerous ancillary techniques utilized in surgical pathology, including immunoperoxidase, cytogenetic, molecular biologic, and electron microscopic studies. The Assistant has additional opportunities for research and electives in surgical pathology-related areas and participates in clinical conferences, including surgical and medical grand rounds. The year provides an invaluable opportunity to develop and refine skills as a diagnostic surgical pathologist under the close supervision of experienced attending pathologists.

Highly desired applicant qualities include the ability to effectively communicate with clinicians, outstanding diagnostic skills, and an enthusiasm to instruct residents. Applicants must have completed their AP training and be AP Board eligible/certified by July, 2016; and they must have a US permanent resident visa or be a US citizen.

Transfusion Medicine

This ACGME-accredited fellowship is a one- or two-year program offered jointly by the Transfusion Medicine Division and Hemapheresis and Transfusion Support (HATS) of The Johns Hopkins Hospital Department of Pathology, with rotations at the American Red Cross blood services headquarters in Baltimore, the Immunogenetics Laboratory of The Johns Hopkins Department of Medicine and the Cellular Therapy Laboratory of The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. Rotations provide exposure to both theoretical concepts and practical experience in blood bank administration, donor procedures, donor testing, reference immunohematology, platelet serology, transfusion consultations, cytapheresis, bone marrow processing, immunogenetics and therapeutic apheresis. A clinically oriented research project is an integral part of the first year and may be continued during the optional second year. The goal of the second year is to prepare the fellow for an investigative career in Transfusion Medicine. Areas of research include the following: platelet and red cell immunohematology, blood donor and recipient epidemiology, alternative transfusion techniques, and the molecular biology of platelets and red cells. Two positions may be offered per year. Requirements: Board eligibility in CP, AP/CP or Hematology.